Exhibit 4.1

EIGHTH SUPPLEMENTAL INDENTURE (this “Eighth Supplemental Indenture”), dated as of August 20, 2013, by and among MPT Operating Partnership, L.P., a Delaware limited partnership (“Opco”), MPT Finance Corporation, a Delaware corporation (“Finco” and, together with Opco, the “Issuers”), Medical Properties Trust, Inc., a Maryland corporation (the “Parent”), as a Guarantor, each of the other Guarantors (as defined in the Indenture), as Subsidiary Guarantors, and Wilmington Trust, National Association, existing under the laws of the United States of America, as Trustee (the “Trustee”).

WHEREAS, the Issuers, Parent and certain of Parent’s subsidiaries have heretofore executed and delivered an Indenture, dated as of February 17, 2012, as supplemented prior to the date hereof (the “Base Indenture,” as amended and supplemented from time to time, the “Indenture”), providing for the initial issuance by the Issuers of $200.0 million aggregate principal amount of 6.375% senior notes due 2022 (the “Initial Notes”);

WHEREAS, Section 9.01(a)(13) of the Base Indenture provides that the Issuers, the Guarantors and the Trustee may amend or supplement the Base Indenture from time to time without the consent of the Holders (as defined in the Indenture) to provide for the issuance of Additional Notes (as defined in the Indenture) in accordance with the limitations set forth in the Base Indenture;

WHEREAS, all things necessary to make the New Notes (as defined below), when executed by the Issuers and authenticated and delivered by the Trustee and issued upon the terms and subject to the conditions set forth herein and in the Base Indenture against payment therefor, the valid, binding and legal obligations of the Issuers and to make this Eighth Supplemental Indenture a valid, binding and legal agreement of the Issuers and the Guarantors, have been done;

NOW THEREFORE, in consideration of the foregoing and for other good and valuable consideration, the receipt of which is hereby acknowledged, the Issuers and each Guarantor and the Trustee mutually covenant and agree for the equal and ratable benefit of the Holders of the Notes as follows:

All Capitalized terms used herein without definition shall have the meanings assigned to them in the Indenture. The rules of interpretation set forth in the Indenture shall be applied here as if set forth in full herein.

“New Notes” means the $150 million aggregate principal amount of Additional Notes issued under this Eighth Supplemental Indenture in accordance with Section 2.02 of the Base Indenture.

The Issuers will be entitled, upon delivery of an Authentication Order and an Opinion of Counsel, subject to their compliance with Section 4.08 of the Base Indenture, to issue the New Notes under this Eighth Supplemental Indenture which will have identical terms as the Initial Notes, other than with respect to the date of issuance and issue price. The Initial Notes and the New Notes issued will be treated as a single class for all purposes under the Indenture.

The Trustee will, upon receipt of an Authentication Order, authenticate New Notes for issue that may be validly issued under this Eighth Supplemental Indenture. The aggregate principal amount of Notes outstanding at any time may not exceed the aggregate principal amount of Notes authorized for issuance by the Issuers pursuant to one or more Authentication Orders, except as provided in the Base Indenture.

A. The Trustee makes no undertaking or representation in respect of, and shall not be responsible in any manner whatsoever for and in respect of, the validity or sufficiency of this Eighth Supplemental Indenture or the proper authorization or the due execution hereof by the Issuers or for or in respect of the recitals and statements contained herein, all of which recitals and statements are made solely by the Issuers.

B. On the date hereof, the Indenture shall be supplemented and amended in accordance herewith, and this Eighth Supplemental Indenture shall form part of the Indenture for all purposes, and the Holder of every Note heretofore or hereafter authenticated and delivered under the Indenture shall be bound thereby. The Trustee accepts the trusts created by the Indenture, as amended and supplemented by this Eighth Supplemental Indenture, and agrees to perform the same upon the terms and conditions of the Indenture, as amended and supplemented by this Eighth Supplemental Indenture.

C. This Eighth Supplemental Indenture shall be deemed to be incorporated in, and made a part of, the Indenture. The Indenture, as amended and supplemented by this Eighth Supplemental Indenture, shall be read, taken and construed as one and the same instrument and all the provisions of the Indenture shall remain in full force and effect in accordance with the terms thereof and as amended and supplemented by this Eighth Supplemental Indenture.

D. THIS EIGHTH SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

E. This Eighth Supplemental Indenture may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, but all such counterparts shall together constitute but one and the same instrument.

IN WITNESS WHEREOF, the partries hereto have caused this Eighth Supplemental Indenture to be duly executed and attested, all as of the date first written above.


Very truly yours,

MPT OPERATING PARTNERSHIP, L.P.

BY: MEDICAL PROPERTIES TRUST, LLC, ITS GENERAL PARTNER

BY: MEDICAL PROPERTIES TRUST, INC., ITS SOLE MEMBER

By:		/s/ R. Steven Hamner
		Name: R. Steven Hamner
		Title: Executive Vice President and Chief Financial Officer

MPT FINANCE CORPORATION

By:		/s/ R. Steven Hamner
		Name: R. Steven Hamner
		Title: President, Secretary and General Manager

MEDICAL PROPERTIES TRUST, INC.

By:		/s/ R. Steven Hamner
		Name: R. Steven Hamner
		Title: Executive Vice President and Chief Financial Officer

MEDICAL PROPERTIES TRUST, LLC

By: MEDICAL PROPERTIES TRUST, INC.,
ITS SOLE MEMBER

By:		/s/ R. Steven Hamner
		Name: R. Steven Hamner
		Title: Executive Vice President and Chief Financial Officer

MPT OF VICTORVILLE, LLC MPT OF BUCKS COUNTY, LLC MPT OF BLOOMINGTON, LLC MPT OF COVINGTON, LLC MPT OF DENHAM SPRINGS, LLC MPT OF REDDING, LLC MPT OF CHINO, LLC MPT OF DALLAS LTACH, LLC

MPT OF PORTLAND, LLC

MPT OF WARM SPRINGS, LLC

MPT OF VICTORIA, LLC

MPT OF LULING, LLC

MPT OF WEST ANAHEIM, LLC

MPT OF LA PALMA, LLC

MPT OF PARADISE VALLEY, LLC

MPT OF SOUTHERN CALIFORNIA, LLC

MPT OF TWELVE OAKS, LLC

MPT OF SHASTA, LLC

MPT OF BOSSIER CITY, LLC

MPT OF WEST VALLEY CITY, LLC

MPT OF IDAHO FALLS, LLC

MPT OF POPLAR BLUFF, LLC

MPT OF BENNETTSVILLE, LLC

MPT OF DETROIT, LLC

MPT OF BRISTOL, LLC

MPT OF NEWINGTON, LLC

MPT OF ENFIELD, LLC

MPT OF PETERSBURG, LLC

MPT OF GARDEN GROVE HOSPITAL, LLC

MPT OF GARDEN GROVE MOB, LLC

MPT OF SAN DIMAS HOSPITAL, LLC

MPT OF SAN DIMAS MOB, LLC

MPT OF CHERAW, LLC

MPT OF FT. LAUDERDALE, LLC.

MPT OF PROVIDENCE, LLC

MPT OF SPRINGFIELD, LLC

MPT OF WARWICK, LLC

MPT OF RICHARDSON, LLC

MPT OF ROUND ROCK, LLC

MPT OF SHENANDOAH, LLC

MPT OF HILLSBORO, LLC

MPT OF FLORENCE, LLC

MPT OF CLEAR LAKE, LLC

MPT OF TOMBALL, LLC

MPT OF GILBERT, LLC

MPT OF CORINTH, LLC

MPT OF BAYONNE, LLC

MPT OF ALVARADO, LLC

MPT OF DESOTO, LLC

MPT OF HAUSMAN, LLC

MPT OF HOBOKEN HOSPITAL, LLC

MPT OF HOBOKEN REAL ESTATE, LLC

MPT OF OVERLOOK PARKWAY, LLC

MPT OF NEW BRAUNFELS, LLC


		MPT OF WESTOVER HILLS, LLC MPT OF WICHITA, LLC MPT OF BILLINGS, LLC MPT OF BOISE, LLC MPT OF BROWNSVILLE, LLC MPT OF CASPER, LLC MPT OF COMAL COUNTY, LLC MPT OF GREENWOOD, LLC MPT OF JOHNSTOWN, LLC MPT OF LAREDO, LLC MPT OF LAS CRUCES, LLC MPT OF MESQUITE, LLC MPT OF POST FALLS, LLC MPT OF PRESCOTT VALLEY, LLC MPT OF PROVO, LLC MPT OF NORTH CYPRESS, LLC MPT OF LAFAYETTE, LLC MPT OF INGLEWOOD, LLC MPT OF RENO, LLC MPT OF ROXBOROUGH, LLC MPT OF ALTOONA, LLC MPT OF HAMMOND, LLC MPT OF SPARTANBURG, LLC MPT OF WYANDOTTE COUNTY, LLC MPT OF LEAVENWORTH, LLC MPT OF CORPUS CHRISTI, LLC By: MPT OPERATING PARTNERSHIP, L.P., SOLE MEMBER OF EACH OF THE ABOVE ENTITIES By: MEDICAL PROPERTIES TRUST, LLC, ITS GENERAL PARTNER

		By: MEDICAL PROPERTIES TRUST, INC., ITS SOLE MEMBER

		By: /s/ R. Steven Hamner Name: R. Steven Hamner Title: Executive Vice President and Chief Financial Officer